92 Decision Citation: BVA 92-13620
Y92
BOARD OF VETERANS' APPEALS
WASHINGTON, D.C. 20420
DOCKET NO. 91-50 904 ) DATE
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THE ISSUE
Entitlement to service connection for a chronic acquired
psychiatric disorder.
REPRESENTATION
Appellant represented by: The American Legion
WITNESS AT HEARING ON APPEAL
Appellant
ATTORNEY FOR THE BOARD
William H. Hickman, Associate Counsel
INTRODUCTION
This matter comes before the Board on appeal from rating
decisions of the Waco, Texas, Regional Office (hereinafter
RO). The veteran had military service from December 1979 to
September 1981. A December 1990 rating decision denied the
veteran's claim. A notice of disagreement was received in
February 1991. A statement of the case was issued in March
1991. A substantive appeal was received in March 1991. The
veteran was afforded a personal hearing in May 1991, and in
September 1991, the hearing officer issued a decision. A
supplemental statement of the case was issued in September
1991. The case was received and docketed at the Board in
December 1991. The veteran's representative submitted
additional written arguments to the Board in March 1992.
The case is now ready for appellate review.
CONTENTIONS OF APPELLANT ON APPEAL
The veteran contends, in essence, that he developed
psychiatric pathology in service that was manifested by
feelings of paranoia and nervousness and that this pathology
has persisted since that time and, therefore, service
connection for a psychiatric disorder is warranted.
DECISION OF THE BOARD
For the reasons and bases hereinafter set forth, it is the
decision of the Board that the evidentiary record is against
the veteran's claim for service connection for a chronic
acquired psychiatric disorder.
FINDINGS OF FACT
1. All relevant evidence necessary for an equitable
disposition of the veteran's appeal has been obtained by the
RO.
2. The evidentiary record does not indicate that the
veteran has a chronic acquired psychiatric disorder of
service origin or attributable thereto.
CONCLUSION OF LAW
A chronic acquired psychiatric disorder was not incurred in
or aggravated by service, nor may a psychosis be presumed to
have been incurred in service. 38 U.S.C. 1101, 1112, 1113,
1131, 1137, 5107 (1992); 38 C.F.R. 3.307, 3.309 (1991).
REASONS AND BASES FOR FINDINGS AND CONCLUSIONS
Initially, we note that we have found the veteran's claim to
be "well-grounded" within the meaning of 38 U.S.C. 5107(a).
That is, we find that he has presented a claim which is
plausible. We are also satisfied that all relevant facts
have been properly developed, and that no further assistance
to the veteran is required to comply with the duty to assist
him mandated by 38 U.S.C. 5107(a).
Historically, the service medical records reveal that in
January 1980 the veteran gave preservice history of drug
experimentation. He underwent a mental status examination
which was negative for psychosis or disabling neurosis.
In June 1980 the service medical records reflect that the
veteran requested help with problems with alcohol. He was
referred to a drug and alcohol counselor. In July 1980 the
veteran complained of nervousness and requested medication.
A history of drug abuse over the past 6 to 10 years was
noted. It was noted that the veteran desired discharge from
the service for the reason that he could not support his
drug habit when out at sea. Mental status examination found
the veteran alert, cooperative and oriented times three.
The veteran's memory, both recent and remote, was intact.
The insight was listed as poor as the veteran did not
understand the effects of drug use on his "nerves."
Impression was of polydrug abuse by history.
The report of a discharge examination dated in September
1981 reported normal psychiatric findings. The veteran
complained of having problems adopting to military service
because of stress and "head" problems.
Of record is the report of a VA psychiatric evaluation dated
in December 1981. The veteran appeared with complaints of
problems communicating with others and related that this had
been so since high school. He reported having no courage to
say anything to anyone since he was a teenager and stated he
felt that this trait had worsened since his service
experience. No previous psychiatric hospitalization or
treatment was indicated. The veteran reported feeling alone
during his high school years and being intimated by his
peers. The veteran admitted to polysubstance abuse during
high school. He denied any current drug abuse. On mental
status examination the veteran was found to be well-groomed
and cooperative. Speech was spontaneous with no disturbance
in articulation. Eye contact was poor. Mood was neutral
with a slightly restricted affect that was not blunted or
flat. The thought processes and continuity were intact and
there was no looseness of association. He was seen as
goal-directed with no delusions or preoccupations. No
suicidal/homicidal thoughts were noted. The veteran was
seen as oriented times three with his memory intact.
Abstraction was seen as concrete and insight and judgment
were listed as good. The examiner reported the veteran to
have low self-esteem and negative self-image. Diagnostic
impression for Axis I was deferred. Impression for Axis II
was of schizoid personality disorder and an avoidant
personality disorder.
Of record are clinical notes from a VA facility also dated
in December 1989. A VA psychiatrist reported that the
veteran had tried to obtain some medication for "nerves" in
the course of a psychiatric evaluation. These notes also
reflect that the veteran had a drug problem which he had
been unable to break. These records reveal the contrast
between the veteran's current admission of drug use and his
denial of the same during the psychiatric evaluation.
VA outpatient clinical records show the veteran was seen
approximately five times in July and August 1982. The
veteran complained of continued feelings of being nervous
around people as well as having low self-esteem. He denied
current drug use and expressed a desire for some medication
to control his nervousness. No definitive diagnosis was
listed.
Clinical records dated in January and February 1983 reflect
continuing complaints of nervousness and low self-esteem
accompanied by denials of any current drug use. A VA
outpatient clinical record dated in December 1984 reported
the veteran's making the same types of complaints. An
assessment was made that the veteran appeared to be showing
signs of psychosis which were deemed to be probably paranoid
schizophrenia. Medication was prescribed.
In April 1990 the veteran appeared at a VA facility
requesting evaluation for a chronic history of problems
dealing with and controlling his anger. He reported being
fired from his job last week after getting into a fight. He
was seen as being dressed and groomed appropriately with
speech clear and no hallucinations, but there was reported
evidence of suspiciousness and paranoia. This assessment
was made by a nonphysician.
In May 1990 the veteran was seen by a physician. He
appeared with complaints of racing thoughts and having ideas
of persecutory grandiosity. Mental status examination found
the veteran to be pleasant and in a euthymic mood. No
delusions were reported. It was noted that the veteran
heard his mother's voice internally when he was under
stress. He was oriented times three. Impression was of a
cyclothymic disorder and rule out a bipolar manic disorder.
Of record is the transcript of a personal hearing held in
May 1991. The veteran testified that he thought he first
experienced nervous or psychiatric problems in 1980 while in
service and serving on a ship. He described feelings of
paranoia. In reference to questions concerning drug use
prior to service, the veteran stated he started
experimenting in the ninth grade, but denied any history
that went back 10 years prior to service. The veteran
testified that he could not remember ever having a thorough
psychiatric evaluation in service. He indicated that he
reported his problems to the service chain of command,
apparently meaning in reference to his feelings of paranoia
and nervousness, and that this resulted in the veteran's
obtaining a discharge from service. The veteran reported a
history of being unable to retain employment post service
because of problems communicating with people.
Under the applicable regulations a grant of service
connection is warranted when the evidentiary record
demonstrates that a psychiatric disorder was incurred in or
aggravated by service, or that a psychosis appeared within
one year of separation from service. 38 U.S.C. 1101, 1112,
1113, 1131, 1137; 38 C.F.R. 3.307, 3.309. It should also be
kept in mind that 38 C.F.R. 3.303(d) states that this
presumptive period is not intended to limit service
connection when the evidence warrants service connection on
a direct basis.
The Board is of the view that the evidentiary record, in the
instant case, does not establish that the veteran has a
chronic acquired psychiatric disorder that had its origins
in service, or within one year following service.
The service medical records demonstrate that the veteran had
a history of drug abuse prior to entering the service, and
that the veteran sought discharge from the service because
he was unable to support his drug habit. While the veteran
did have complaints of nervousness in service, there is no
service medical record, inclusive of the report of the
discharge examination, which demonstrates the existence of
any chronic acquired psychiatric pathology.
Likewise, the VA clinical records do not reflect the
appearance of any psychiatric pathology until a VA
outpatient examination in December 1984 assessed the veteran
as appearing to be showing signs of psychosis. In this
regard, it must be remembered that the mental status
examination performed on the veteran in December 1981 was
absent of any symptomatology indicative of any underlying
psychiatric pathology. The veteran's thought processes were
seen as being continuous and intact with no looseness of
association. He was seen as oriented times three with his
insight and judgment being listed as good. The problems
diagnosed at this time were of two different types of
personality disorders, schizoid and avoidant. Personality
disorders are in the nature of developmental disorders which
are not eligible for service connection. 38 C.F.R.
3.303(c).
In reaching this decision, the Board has considered the
doctrine of affording the veteran the benefit of any doubt
with respect to the issue on appeal. However, the
evidentiary record is not approximately balanced in its
positive and negative aspects so as to decide this matter on
that basis.
ORDER
Service connection for a chronic acquired psychiatric
disorder is denied.
BOARD OF VETERANS' APPEALS
WASHINGTON, D.C. 20420
*
NANCY R. ROBIN (MEMBER TEMPORARILY ABSENT)
ALBERT D. TUTERA
*38 U.S.C. § 7102(a)(2)(A) (1992) permits a Board of
Veterans' Appeals Section, upon direction of the Chairman of
the Board, to proceed with the transaction of business
without awaiting assignment of an additional Member to the
Section when the Section is composed of fewer than three
Members due to absence of a Member, vacancy on the Board or
inability of the Member assigned to the Section to serve on
the panel. The Chairman has directed that the Section
proceed with the transaction of business, including the
issuance of decisions, without awaiting the assignment of a
third Member.
NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C. § 7266 (1992),
a decision of the Board of Veterans' Appeals granting less
than the complete benefit, or benefits, sought on appeal is
appealable to the United States Court of Veterans Appeals
within 120 days from the date of mailing of notice of the
decision, provided that a Notice of Disagreement concerning
an issue which was before the Board was filed with the
agency of original jurisdiction on or after November 18,
1988. Veterans' Judicial Review Act, Pub. L. No. 100-687,
§ 402 (1988). The date which appears on the face of this
decision constitutes the date of mailing and the copy of
this decision which you have received is your notice of the
action taken on your appeal by the Board of Veterans'
Appeals.